Season 1
Episode 9 - DNR
Brief Plot Summary
John Henry Giles is a famous trumpet player who is stuck on a wheelchair from what was diagnosed as ALS. House doesn't believe he has ALS and searches for alternative diseases. Wegener's is his next guess, but he is proven worng. An embolectomy is done to remove a clot in his brain and all treatment is stopped to determine which drug is effective. Another MRI reveals that John was suffering from Arteriovenous Malformation that compressed his spine and caused paralysis to his legs.
John Henry Giles is a famous trumpet player who is stuck on a wheelchair from what was diagnosed as ALS. House doesn't believe he has ALS and searches for alternative diseases. Wegener's is his next guess, but he is proven worng. An embolectomy is done to remove a clot in his brain and all treatment is stopped to determine which drug is effective. Another MRI reveals that John was suffering from Arteriovenous Malformation that compressed his spine and caused paralysis to his legs.
Diagnosed Disease: Arteriovenous Malformation (AVM) - An arteriovenous malformation is an abnormal connection between the arteries and veins. This can cause a variety of sympotoms but in most cases, it is asymptomatic. It is usually harmful when it occurs in the nervous system, namely the spinal cord and brain. In this episode, this causes paralysis in the patient's legs.
SymptomsParalysis, difficulty in coordination and speech, seizures, headaches, bleeding from hemorrhages, heart failure, and other problems depending on the location of the AVM.
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CausesAVMs occur during fetal development so the cause may be a genetic predisposition or just a mutation.
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Tests |
Treatment/CureSurgery is required to remove the AVM by inserting a coil to block or plug that space.
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Source Links: NIH Page, NINDS Page
Episode 10 - Histories
Brief Plot Summary
A homeless woman is admitted after a party bust with legions on her skin and a twitchy wrist. A surgical pin in her arm reveals her name, Victoria Matson, and from her records House thinks that she has a tuberculoma mass. However, she then gets a 105 fever suggesting that the diagnosis is correct but the treatment is killing her. Insensivity in her leg leads House to conclude that she has rabies.
A homeless woman is admitted after a party bust with legions on her skin and a twitchy wrist. A surgical pin in her arm reveals her name, Victoria Matson, and from her records House thinks that she has a tuberculoma mass. However, she then gets a 105 fever suggesting that the diagnosis is correct but the treatment is killing her. Insensivity in her leg leads House to conclude that she has rabies.
Diagnosed Disease: Rabies - Rabies is a deadly viral infection that is contracted through infected saliva and that attacks the brain by inhibiting protein synthesis in the neurons. The reason it is able to evade the immune system is because it only infects nerve cells where the immune system is not able to reach it. From there it travels to the brain. The only way to cure is to stimulate production of active microglia (central nervous system macrophages) which are the only lymphocyte capable of fighting off infection in the central nervous system.
SymptomsFirst symptom onsets feel like the flu followed by seizures, hand twitches, high fever, insensitivity to touch, muscles spasms, restlessness.
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CausesContracted via saliva from an infected animal bite. However, if the wound is cleaned immediately, rabies threat can be eliminated 99% of the time.
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TestsThe virus can be detected through a saliva sample, spinal fluid, or nerve biopsy.
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Treatment/CureTreatment is usually a strict 28 day regime of vaccine shots in order to stimulate production and sensitize microglia in order to fight off the infection. Sometimes the infected tissue is cut out to prevent spread. However, the immune system must eventually fight the virus by itself.
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Episode 11 - Detox
Brief Plot Summary
Keith decides to take his Dad's Porche for a spin with his girlfriend. They get in a car crash and Keith's case is taken up by the team because he has had internal bleeding for three weeks. He displays all four stages of Lupus, expect in the span of a week. A hallucination of a dead cat prompts House to perform a biopsy on the cat and diagnose Keith with naphthalene poisoning caused by the release of naphthalene gas stored in Keith's fat that was burned as he sat at the hospital, inhaled in his home from a termite infestation.
Keith decides to take his Dad's Porche for a spin with his girlfriend. They get in a car crash and Keith's case is taken up by the team because he has had internal bleeding for three weeks. He displays all four stages of Lupus, expect in the span of a week. A hallucination of a dead cat prompts House to perform a biopsy on the cat and diagnose Keith with naphthalene poisoning caused by the release of naphthalene gas stored in Keith's fat that was burned as he sat at the hospital, inhaled in his home from a termite infestation.
Diagnosed Disease: Naphthalene Poisoning - Naphthalene is a simple two-ring aromatic hydrocarbon found in moth balls and produced by termites. Naphthalene eventually turns to gas and can be inhaled which is how Keith got poisoned. Too much exposure is speculated to be carcinogenic and proven to lead to hemolytic anemia.
SymptomsHemolytic anemia (destruction of red blood cells) causing tissue necrosis from a lack of oxygen, kidney and liver damage, headaches, nausea, jaundice, convulsions.
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CausesNaphtalene exposure from inhaled air, skin contact, or ingestion.
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TestsBlood tests may reveal the poison, but diagnosis is mainly based off of conditions and history.
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Treatment/CureGastric lavage can be performed immediately, and sometimes blood transfusions are needed.
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Source Links: NIH Page
Episode 12 - Sports Medicine
Brief Plot Summary
A major league baseball player, Hank Wiggen, breaks his arm during a pitch for an anti-drug commercial. House suspects steroids after noticing that Hank has hypogonadism (shrinking of the testes), and it explains his kidney problems and bone loss. However, treatment, Lupron, causes more respiratory problems. The team can no longer stabilize his heart rate. When his wife, Lola, can't smell, House realize that they both have cadmium poisoning from marajuana.
A major league baseball player, Hank Wiggen, breaks his arm during a pitch for an anti-drug commercial. House suspects steroids after noticing that Hank has hypogonadism (shrinking of the testes), and it explains his kidney problems and bone loss. However, treatment, Lupron, causes more respiratory problems. The team can no longer stabilize his heart rate. When his wife, Lola, can't smell, House realize that they both have cadmium poisoning from marajuana.
Diagnosed Disease: Cadmium Poisoning - Cadmium is extremely poisonous and even 10 miligrams can cause symptoms. It has no function in the body and is one of the most poisonous metals.
SymptomsKidney failure, flu-like symptoms, respiratory damage, osteopenia (loss of calcium from bones) which causes brittleness and makes bones break.
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Causes.Cadmium exposure can occur from paint, factories that make batteries and plastics, cigarettes and fertilizers. In the episode, the couple was poisoned from the smoking marajuana grown using such a fertilizer.
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TestsEasiest test for cadmium poisoning is a urine test since the kidneys will eventually have to filter the cadmium out of the body.
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Treatment/CureThere is no known treatment for cadmium poisoning.
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Source Links: British Medical Journal Review Article, US Dept. of Labor
